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Introduction: The aims of this systematic review and meta‐analysis were to determine if after hip fracture surgery (1) early mobilisation is associated with improved clinical outcomes, and if so (2) are benefits directly proportional to how soon after surgery the patient mobilises. Methods: A Preferred Reporting Items for Systematic Reviews and Meta‐Analyses systematic review was conducted using four databases to identify all studies that compared postoperative early mobilisation with delayed mobilisation, in patients after hip fracture surgery. The Critical Appraisal Skills Programme checklist was employed for critical appraisal and evaluation of all studies that met the inclusion criteria. Results: A total of 13 studies, including 297,435 patients were identified, of which 235,275 patients were mobilised early and 62,160 were mobilised late. Six studies assessed 30‐day mortality, of which two also investigated 30‐day complication rates. Pooled meta‐analysis demonstrated that there were significantly lower 30‐day mortality rates (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.31–0.41, p < 0.001) and complication rates (OR 0.43, 95% CI 0.36–0.51, p < 0.001) in patients mobilising early after hip fracture surgery. Five studies investigated length of stay (LOS) and meta‐analysis revealed no difference between groups (mean difference −0.57 days, 95% CI −1.89–0.74, p = 0.39). Conclusion: Early mobilisation in hip fracture patients is associated with a reduction in 30‐day mortality and complication rates compared to delayed mobilisation, but no difference in LOS. These findings illustrate that early mobilisation is associated with superior post operative outcomes. However, a direct casual effect remains to be demonstrated, and further work on the factors underlying delayed mobilisation is required. [ABSTRACT FROM AUTHOR]

Objective: Dravet syndrome (DS) is a severe developmental and epileptic encephalopathy, leading to reduced health‐related quality of life (HRQOL). Prospective outcome data on HRQOL are sparse, and this study investigated long‐term predictors of HRQOL in DS. Methods: One hundred thirteen families of SCN1A‐positive patients with DS, who were recruited as part of our 2010 study were contacted at 10‐year follow‐up, of which 68 (60%) responded. The mortality was 5.8%. Detailed clinical and demographic information was available for each patient. HRQOL was evaluated with two epilepsy‐specific instruments, the Impact of Pediatric Epilepsy Scale (IPES) and the Epilepsy & Learning Disabilities Quality of Life Questionnaire (ELDQOL); a generic HRQOL instrument, the Pediatric Quality of Life Inventory (PedsQL); and a behavioral screening tool, the Strength and Difficulties Questionnaire (SDQ). Results: Twenty‐eight patients were 10–15 years of age (0–5 years at baseline) and 40 were ≥16 years of age (≥6 years at baseline). Patients 0‐ to 5–years‐old at baseline showed a significant decline in mean scores on the PedsQL total score (p =.004), physical score (p <.001), cognitive score (p =.011), social score (p =.003), and eating score (p =.030) at follow‐up. On multivariate regression, lower baseline and follow‐up HRQOL for the whole cohort were associated with worse epilepsy severity and a high SDQ total score (R2 = 33% and 18%, respectively). In the younger patient group, younger age at first seizure and increased severity of epilepsy were associated with a lower baseline HRQOL (R2 = 35%). In the older age group, worse epilepsy severity (F = 6.40, p =.016, R2 = 14%) and the use of sodium‐channel blockers were independently associated with a lower HRQOL at 10‐year follow‐up (F = 4.13, p =.05, R2 = 8%). Significance: This 10‐year, prospective follow‐up study highlights the significant HRQOL‐associated cognitive, social, and physical decline particularly affecting younger patients with DS. Sodium channel blocker use appears to negatively impact long‐term HRQOL, highlighting the importance of early diagnosis and disease‐specific management in DS. [ABSTRACT FROM AUTHOR]